Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Facility		$48.56	$48.56	$48.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.70 / $48.56 / $48.56	Professional		$45.70	$48.56	$48.56
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,111.16 / $1,307.25 / $1,960.88	Facility		$1,111.16	$1,307.25	$1,960.88
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,307.25 / $1,307.25 / $1,307.25	Professional		$1,307.25	$1,307.25	$1,307.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Facility		$48.56	$48.56	$48.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Professional		$48.56	$48.56	$48.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $152.78 / $1,338.75 / $1,338.75	Professional		$152.78	$1,338.75	$1,338.75
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $48.56 / $48.56 / $82.07	Facility		$48.56	$48.56	$82.07
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $45.70 / $48.56 / $57.79	Professional		$45.70	$48.56	$57.79
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Facility		$48.56	$48.56	$48.56
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Professional		$48.56	$48.56	$48.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,576.28 / $1,576.28 / $1,576.28	Facility		$1,576.28	$1,576.28	$1,576.28
United Facility/Professional Professional Modifier Low / Median / High Price $54.27 / $57.13 / $71.41	Professional		$54.27	$57.13	$71.41